Exercise-Induced Asthma test

Children and young people with asthma or who experience ‘asthma’ symptoms may be referred for a test called the Exercise-Induced Asthma (EIA) test. The test aims to assess if your child is at risk of an asthma attack during exercise. This information sheet from Great Ormond Street Hospital (GOSH) describes what to expect when your child is booked for an EIA test. 
Many of us will experience a feeling of shortness of breath or become hot and sweaty when we exercise, which is normal. However, for those who suffer with exercise-induced asthma, the airways will not respond in a normal way to exercise. 
 
Children and young people who suffer with exercise induced asthma may complain of very severe shortness of breath, difficulty to breathe, coughing or chest tightness. For known asthmatics, they may feel they are unable to take part in physical exercise.

What is exercise-induced asthma?

For children and young people who suffer with exercise-induced asthma during or after exercise, the airways can become inflamed and will narrow (known as bronchoconstriction). With bronchoconstriction, the child will experience the symptoms mentioned above.
 
Any physical exercise can cause bronchoconstriction. However, it is more commonly seen in vigorous exercise when taken outdoors. This is because the cold air and exercise causes an irritant affect in the airways.

Do I need to bring anything?

You should receive a letter with the instructions on where to come and if any medication will need to be stopped before the test. Please bring your child’s asthma medication including inhalers with you.
 
For the exercise test, your child should ideally wear shoes that they can run in, ideally a pair of trainers. They should also wear comfortable clothing. 

What happens during the EIA test?

The Physiologist will explain about the test in more detail on the day if required. We will ask for your permission (consent) to perform the test. If your child has any medical problems, please tell us about these. We will confirm that your child has stopped any medication for the test (if needed) before we start. 

Important

The person bringing your child for the test should have ‘Parental Responsibility’ for them. Parental Responsibility refers to the individual who has legal rights, responsibilities, duties, power and authority to make decisions for a child. If the person bringing your child does not have Parental Responsibility, we may have to cancel the test.

What does the EIA test involve?

We will start by carrying out a breathing test called ‘spirometry’ before the exercise test. This is to assess your child’s baseline lung function. Next we will put a saturation probe on their finger to measure their heart rate and oxygen levels. 
 
For this test we will ask your child to run or walk fast on a treadmill. If your child is unable to complete the exercise on a treadmill, we might decide that your child can run on the spot or use another type of exercise equipment to carry out the ‘vigorous’ exercise. 
 
Two Physiologists will run the test with medical supervision provided by a doctor or specialist nurse to ensure safety. The speed and grade of the treadmill will be controlled by the Physiologist. Please note, the aim is for your child to be exercising at a high level.
 
After the exercise is finished, your child will repeat the spirometry test at various time intervals. This is to assess for any airway narrowing as a result of the exercise. 
 
The doctor or nurse may listen to your child’s chest and will ask your child about any symptoms. Usually, bronchoconstriction takes place five minutes after exercise and this shows in your child’s spirometry results. 
 
If your child needs it, we will give them salbutamol (a short-acting bronchodilator medication) via a spacer and inhaler to reverse the narrowing present in the airways triggered by the exercise. Spirometry will be repeated to see if the medication improves airflow. 
 
Once this has been completed and the Physiologist is happy that your child has recovered from the test, you will be able to go home. 

Are there any risks?

EIA tests carried out in hospital are very safe – the Physiologists are experienced in carrying out the test. 
 
Your child’s baseline spirometry results will be assessed and, in some circumstances checked with a respiratory consultant before starting the exercise test. 
 
Your child will be monitored throughout the whole test and a doctor or senior nurse is present during and after the exercise for safety. A reliever inhaler will be administered if your child requires it and you will only be allowed to go home once it is safe to do so. 
 
Please also note if your child is finding the treadmill difficult and alternative forms of vigorous exercise are not possible, the Physiologist may decide that it is unsafe, so the test may be stopped. 

Getting the results

The results for you test will be uploaded onto our electronic patient record system for your doctor to view. If you are seeing your doctor in clinic or later that day, they will go through the results with you. If you are not seeing the doctor that day, they will still be able to view your test results and contact you if your child needs to do anything before their next appointment. 
Compiled by: 
The Lung Function Laboratory in collaboration with the Child and Family Information Group
Last review date: 
April 2020
Ref: 
2020F2307

Disclaimer

Please note this is a generic GOSH information sheet. If you have specific questions about how this relates to your child, please ask your doctor. Please note this information may not necessarily reflect treatment at other hospitals.